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A Veterans Administration (VA) study found suffering traumatic events and moral injury in the past can increase pregnancy risk in the future.

Researchers at the National Center for Post-Traumatic Stress Disorder (PTSD) at the VA Boston Healthcare System and Boston University School of Medicine evaluated 318 women who became pregnant within three years of separating from the military.  As a result of the research, study authors suggest “screening for PTSD and moral injury during the perinatal period is important to identify women who may need treatment for these problems.”

The research, published in the  Journal of Traumatic Stress, is important not only for its evaluation of women veterans but for all women who may have experienced moral injury or traumatic events prior to becoming pregnant.  PTSD refers to the experience of anxiety, flashbacks, insomnia and other symptoms as a result of suffering through a traumatic event.

While such events are often equated with the battlefield, they also occur in civilian, domestic life. Moral injury (MI) is a term used to describe an experience that goes far and beyond the moral beliefs that we each use to navigate our world.  Experiencing a moral injury is a shock to the very system that we use to decide what is right and wrong in the world and can lead to guilt, deep shame, and confusion, among other symptoms.

While lay readers may consider the causes and damage of PTSD and MI to be similar, they are distinctly different.  In this study, two tools were used including the Moral Injury Events Scale and the DSM-5 Primary Care PTSD Screen.  While earlier studies have found that PTSD can impact pregnancy, MI is less understood with regard to adverse outcomes during pregnancy.

Findings of the study include:

  • PTSD is known to increase risk of premature birth, gestational diabetes, and preeclampsia. This study concurred with earlier studies and also found that PTSD, not moral injury, was more likely to be associated with postpartum depression.
  • In this study, MI was similarly found to increase the risk of gestational diabetes, preterm birth, and preeclampsia.
  • The more severe the symptoms of either PTSD or MI, the more severe the impact upon the pregnancy.

This study points to the importance of early assessment of pregnant women who may be service veterans or who may otherwise suffer from symptoms caused by PTSD or moral injury.  Early knowledge of these conditions could inform obstetric care and possibly prevent serious complications or injury to mom or baby later in the pregnancy.

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